Collaborative development of a digital intervention to support opioid tapering after surgery in primary care: an...

To co-design a digital intervention (eTAPER) to support safe and timely opioid tapering after surgery in primary care, integrating behavioural theory and stakeholder perspectives.

Qualitative co-design study using two online co-design workshops and one in-person stakeholder engagement event guided by the Experience-Based Co-Design (EBCD) methodology and mapped to the Theoretical Domains Framework. Qualitative data were collected during the two online co-design workshops, while the in-person stakeholder engagement event was used to sense-check and validate the findings from the workshops. No new data were collected during the stakeholder engagement event.

Two online co-design workshops and one in-person stakeholder event were conducted as part of the EBCD process.

8 adult post-surgical patients with experience of opioid use and 12 healthcare professionals (general practitioners, clinical pharmacists and anaesthetists) involved in pain management participated. Among patients, 5/8 were female and 5/8 were white British; ages ranged from 25 to 84 years. Among healthcare professionals, 7/12 were female; participants included pharmacists and doctors working across primary care, secondary care and academic settings, with most reporting >10 years of professional experience.

Five key behavioural domains were identified as influencing opioid tapering (environmental context and resources, skills, social/professional role and identity, knowledge and beliefs about consequences). Corresponding behaviour change techniques were embedded within the prototype eTAPER tool. Barriers included poor continuity of care, limited tapering guidance and workforce pressures, while enablers included pharmacist-led reviews and digital education tools. The intervention was refined through iterative workshops to ensure feasibility, usability and alignment with clinical workflows.

This study demonstrates how EBCD can translate lived experience into a scalable digital health intervention. The eTAPER tool offers a theory-informed, co-designed approach to supporting safe opioid tapering after surgery. Further evaluation is needed to assess its effectiveness, usability and transferability across healthcare settings.